1998, 11-04 Notice of Unsatisfactory ConditionBUILDING AND PLANNING
JAMES L. MANSON, C.B.O., DIRECTOR
Tina M. Scott
19027 E. Nixon
Spokane, WA 99216
A DIVISION OF THE PUBLIC WORKS DEPARTMENT
DENNIS M. SCOTT, P.E., DIRECTOR
November 4, 1998
RE: Notice of Unsatisfactory Condition - 19027 E. Nixon
To Whom It May Concern:
Our office has been informed that an unsatisfactory condition may exist with regard to the furnace, located
at the referenced address.
This notice is to inform you that should you install new equipment, you must obtain a permit.
Should you have any questions, please contact this office between the hours of 8:00 a.m. and 4:00 p.m. Our
phone number is: (509) 477-3675.
Sincerely,
Lois Ann Douglas
Office Assistant -4
1026 NEST BROADWAY AVENUE • SPOKANE, WASHINGTON 99260
PHONE: (509) 456-3675 • FAX: (509) 456-4703
TDD: (509) 324-3166
w
>Q
W Z
cc LLJ
W Ll1
CO m
F-
O
ZQ
2 LC
Ow
J
z
301 (6/92)
ADDRESS
CUSTOMER NAME
FORM FURNISHED BY INLAND NORTHWEST HVAC ASSOCIATION.
((c�
N? 018966
OWNER o 'PRINT NAME
AGENT 0
USTO ERSIGNATU'E
TYPE NOTIFICATION
HAZARD
❑ WARNING
CONDITION TO BE CORRECTED AS SHOWN BELOW CREATES AN IMMEDIATE HAZARD THIS EQUIPMENT
MUST NOT BE PUT BACK IN SERVICE UNTIL REPAIRS AND A THOROUGH INSPECTION HAVE BEEN
MADE. ISSUER'S PHONE NO
CONDITION TO BE CORRECTED AS SHOWN BELOW IS NOT IN ACCORDANCE WITH SAFETY STANDARDS
AND COULD CREATE A HAZARD. CORRECTIONS AND A THOROUGH INSPECTION MUST BE MADE
WITHIN TWO WEEKS. ISSUER'S PHONE NO
(AFP -05-66
DITION TO' BE CORRECTED4 40 fwf t /6
D J/)f 1114C,uE
TAGGED BY COMPANY
("l! (til
INITIA40
Ti. 3(`
J
DF�IE,� _ /rte
lly'�J!
REPAIRED BY COMPANY
INI L/LJ
TIME
DATYL /�/yy
CONDITION CORRECTED
YES ❑ NO ❑
INTALLED HAZARD TAG YES C NO ❑
I
COPIES SENT TO: (1) CUSTOMER (2) ISSUER (3) AUTHORITY HAVING JURISDICTION (4) EQUIPMENT TAG/
RECEIVED
SPOKANE COUNTY
CT 39 1998
DIVISION OF AIILDING AND PLANNING
aY:
•